Fibular Head

caput fibulae

The head of the fibula is the expanded proximal end of the fibula, forming the proximal tibiofibular joint with the posterolateral facet of the lateral tibial condyle. The fibular head presents a styloid process superiorly for attachment of the fibular collateral ligament and biceps femoris tendon, and its medial surface bears the articular facet. The common peroneal nerve winds around the posterior aspect of the fibular neck immediately below the head.

Region: Knee

Clinical Relevance

Clinical Notes

The fibular head is a critical surgical landmark because the common peroneal nerve wraps around the neck of the fibula immediately distal to the head, making this the most vulnerable site for peroneal nerve injury from plaster cast pressure, direct blows, crossing the legs, and surgical positioning. Biceps femoris tendinopathy and LCL injuries are assessed by palpation at the fibular head. Proximal tibiofibular joint instability produces lateral knee pain and a subtle anterior fibular head prominence.

Pathology

Common Injuries & Conditions

Common Peroneal Nerve Palsy at Fibular Head

Compression of the nerve as it winds around the fibular neck from leg crossing, tight cast or brace, or direct trauma produces foot drop with loss of ankle dorsiflexion and toe extension, with numbness over the dorsum of the foot and lateral shin.

Fibular Head Avulsion Fracture

The LCL and biceps femoris tendon can avulse the fibular styloid in high-energy posterolateral knee injuries, an important indicator of posterolateral corner disruption requiring surgical repair.